Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35.131961 | OH |
NPI | 1538452321 |
---|---|
Provider Name | Nicole Marie Shirilla |
First Address | Columbus, OH 43202-1579 |
Second Address | Columbus, OH 43210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2011 |
Last Update Date | 02/07/2018 |