Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | AG01200073 | OH |
NPI | 1659901650 |
---|---|
Provider Name | Mrs. Julie Carroll |
First Address | Dayton, OH 45458-3286 |
Second Address | Dayton, OH 45458-1847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2020 |
Last Update Date | 19/01/2020 |