Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 025734 | OH |
NPI | 1053941518 |
---|---|
Provider Name | Luciana Sonnenlitter |
First Address | Avon Lake, OH 44012-1009 |
Second Address | Avon Lake, OH 44012-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2020 |
Last Update Date | 17/02/2020 |