Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | DR58479 | CO |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 35.138896 | OH |
NPI | 1164840310 |
---|---|
Provider Name | Jane Koo |
First Address | Cincinnati, OH 45229 |
Second Address | Cincinnati, OH 45229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2014 |
Last Update Date | 30/08/2021 |