Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 10318271-1205 | UT |
NPI | 1538390869 |
---|---|
Provider Name | Poorna Lingeswari Nalabothu |
First Address | Atlanta, GA 30374-1729 |
Second Address | Salt Lake City, UT 84124-1236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 10/02/2022 |