Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 46015 | KY |
NPI | 1033420369 |
---|---|
Provider Name | Sandhya Pahuja |
First Address | Bowling Green, KY 42103-9099 |
Second Address | Munfordville, KY 42765-9435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2010 |
Last Update Date | 16/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100261490 | (05) | KY |