Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 71133-8050 | LA |
NPI | 1194931535 |
---|---|
Provider Name | Sheela B. Garudaiyengar |
First Address | Shreveport, LA 71103-4228 |
Second Address | Shreveport, LA 71103-4228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 26/03/2009 |