Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 35.131630 | OH |
NPI | 1417290339 |
---|---|
Provider Name | Dr. Lisa Caronia Hickman |
First Address | Columbus, OH 43221-2800 |
Second Address | Columbus, OH 43221-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 19/08/2020 |