Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 0401417066 | VA |
NPI | 1124543509 |
---|---|
Provider Name | Dr. Ashli Holland |
First Address | Columbus, OH 43204-4343 |
Second Address | Columbus, OH 43204-4343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2017 |
Last Update Date | 05/08/2020 |