Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 35.091865 | OH |
NPI | 1093899965 |
---|---|
Provider Name | Julierut Tantibhedhyangkul |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2832671 | (05) | OH |
I31321 | (02) |