Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 69848 | GA |
NPI | 1447432471 |
---|---|
Provider Name | Valeria Moncayo |
First Address | Atlanta, GA 30322-1059 |
Second Address | Atlanta, GA 30322-1059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2007 |
Last Update Date | 20/05/2013 |