Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 35-082509 | OH |
NPI | 1275618688 |
---|---|
Provider Name | Giselle S Weller |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45267-2827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 20/06/2017 |