Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 01063356 | IN |
NPI | 1013108216 |
---|---|
Provider Name | Ronda Brinley |
First Address | Indianapolis, IN 46268-0952 |
Second Address | Greenfield, IN 46140-1270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 21/10/2007 |