Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 35.061105 | OH |
N | 2080P0216X | Pediatric Rheumatologist | 46051 | KY |
NPI | 1033187232 |
---|---|
Provider Name | Michael Henrickson |
First Address | Cincinnati, OH 45229-3039 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 05/09/2018 |