Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35.060090 | OH |
NPI | 1003808007 |
---|---|
Provider Name | Dr. Sara F Guerrero-Duby |
First Address | Dayton, OH 45404-1815 |
Second Address | Dayton, OH 45404-2070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 28/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0790863 | (05) | OH |
G47141 | (02) |