Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 34012313 | OH |
NPI | 1053553768 |
---|---|
Provider Name | Dr. Mary Christa Krupski |
First Address | Cincinnati, OH 45229-3126 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2009 |
Last Update Date | 05/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201070810 | (05) | IN |
7100131680 | (05) | KY |