Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD30727 | TN |
NPI | 1124115258 |
---|---|
Provider Name | Sallaya Chinratanalab |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H25964 | (02) |