Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35039742 | OH |
NPI | 1194759118 |
---|---|
Provider Name | Ann Clark Ghory |
First Address | Cincinnati, OH 45255-2498 |
Second Address | Cincinnati, OH 45255-2498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 25/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0496735 | (05) | OH |
A78349 | (02) | OH |