Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 35142143 | OH |
NPI | 1174054431 |
---|---|
Provider Name | Roberta Azbell |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2017 |
Last Update Date | 12/07/2021 |