Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 34011417 | OH |
N | 2084N0600X | Clinical Neurophysiologist | 34011417 | OH |
NPI | 1174811129 |
---|---|
Provider Name | Dara Albert |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2011 |
Last Update Date | 03/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0119324 | (05) | OH |