Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist |
NPI | 1023532587 |
---|---|
Provider Name | Daria Gutkin |
First Address | Cleveland, OH 44106-1702 |
Second Address | Cleveland, OH 44106-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2017 |
Last Update Date | 02/05/2020 |