Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0127X | Trauma Surgeon | PENDING | SC |
NPI | 1154917383 |
---|---|
Provider Name | Nicole Ann Ochs |
First Address | Newport, MI 48166-9315 |
Second Address | Columbia, SC 29203-6839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2020 |
Last Update Date | 11/12/2020 |