Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD16363 | RI |
NPI | 1447570122 |
---|---|
Provider Name | Tarra Evans |
First Address | Providence, RI 02905-4513 |
Second Address | Providence, RI 02904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2010 |
Last Update Date | 25/07/2018 |