Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | E-9360 | AR |
NPI | 1053601575 |
---|---|
Provider Name | Noadia Worku |
First Address | Monticello, AR 71657-0510 |
Second Address | Monticello, AR 71655-4326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 19/12/2018 |