Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 35.094838 | OH |
NPI | 1023125994 |
---|---|
Provider Name | Dr. Holly B. Hahn |
First Address | Maitland, FL 32751-7176 |
Second Address | Dayton, OH 45458-1632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 15/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F72919 | (02) | |
F72919 | (02) | NY |