Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 5719 | GA |
Y | 207RX0202X | Medical Oncology | 80952 | GA |
NPI | 1285990309 |
---|---|
Provider Name | Nisha Sara Joseph |
First Address | Atlanta, GA 30303-3033 |
Second Address | Atlanta, GA 30303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 29/10/2018 |