Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 01081931A | IN |
N | 207VX0201X | Gynecologic Oncologist | 34967 | AL |
NPI | 1053677591 |
---|---|
Provider Name | Sarah Dilley |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 17/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300024405 | (05) | IN |