Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 26127 | NE |
NPI | 1043435068 |
---|---|
Provider Name | Sowmini Oomman |
First Address | Bozeman, MT 59715-6904 |
Second Address | Dickson, TN 37055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 26/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD54269 | TN MEDICAL LICENSE (01) | TN |
Q022759 | (05) | TN |