Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 35.089263 | OH |
NPI | 1013131101 |
---|---|
Provider Name | Jacqueline Graham |
First Address | Chillicothe, OH 45601-9031 |
Second Address | Chillicothe, OH 45601-9031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 14/04/2021 |