Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.251208 | OH |
NPI | 1063094571 |
---|---|
Provider Name | Katherine Marie Miller |
First Address | Cleveland, OH 44111-3135 |
Second Address | Cleveland, OH 44195-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2021 |
Last Update Date | 14/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063094571 | (05) | OH |