Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 31550 | NE |
NPI | 1023062999 |
---|---|
Provider Name | Aviva Abosch |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68131-2813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 09/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0598151 | (05) | IA |
H67566 | (02) | |
H67566 | (02) | MN |