Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 33934 | NE |
NPI | 1093177578 |
---|---|
Provider Name | Sudha Nandala |
First Address | Omaha, NE 68124-2311 |
Second Address | Omaha, NE 68124-2323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 08/02/2022 |