Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35096181 | OH |
NPI | 1003904566 |
---|---|
Provider Name | Dr. Lysa Marleen Aemmer |
First Address | Toledo, OH 43604-7101 |
Second Address | Toledo, OH 43615-7173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 31/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3112643 | (05) | OH |