Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist |
NPI | 1770531642 |
---|---|
Provider Name | Prof. Sallie B. Freeman |
First Address | Atlanta, GA 30307-1226 |
Second Address | Decatur, GA 30033-5307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |