Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 35.096017 | OH |
Y | 207RP1001X | Pulmonary Disease | 35.096017 | OH |
NPI | 1073799045 |
---|---|
Provider Name | Sindhu Bhairavi Mukku |
First Address | Columbus, OH 43202-1579 |
Second Address | Columbus, OH 43221-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2008 |
Last Update Date | 02/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3095092 | (05) | OH |