Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 373940 | OH |
NPI | 1033608732 |
---|---|
Provider Name | Rebecca Mourne |
First Address | Loveland, OH 45140-9370 |
Second Address | Cincinnati, OH 45242-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2018 |
Last Update Date | 08/05/2018 |