Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 35081960 | OH |
NPI | 1083603971 |
---|---|
Provider Name | Nora Gerson |
First Address | Fairborn, OH 45324-9441 |
Second Address | Wright Patterson Afb, OH 45433-5546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 08/07/2007 |