Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D87648 | MD |
Y | 208600000X | Surgeon | D87648 | MD |
N | 208D00000X | General Practice Physician | ME 118159 | FL |
NPI | 1043576804 |
---|---|
Provider Name | Lindy Michelle Rosal |
First Address | Dayton, OH 45409-2722 |
Second Address | Dayton, OH 45409-2722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 20/05/2020 |