Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 35120788 | OH |
NPI | 1275846370 |
---|---|
Provider Name | Dr. Indu Sivaraman |
First Address | Willoughby Hills, OH 44094-9004 |
Second Address | Willoughby Hills, OH 44094-9004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2010 |
Last Update Date | 14/05/2021 |