Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 040565 | OH |
NPI | 1386116473 |
---|---|
Provider Name | Christopher Charles Federer |
First Address | Akron, OH 44305-3546 |
Second Address | Akron, OH 44305-3546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2018 |
Last Update Date | 30/12/2018 |