Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 2012-00346 | NC |
Y | 207SG0201X | Clinical Genetics (M.D.) | 35.133868 | OH |
N | 208000000X | Pediatrician | 036117459 | IL |
NPI | 1841486974 |
---|---|
Provider Name | Dr. Loren D.m. Pena |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2007 |
Last Update Date | 22/05/2018 |