Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 03970 | KY |
NPI | 1043579766 |
---|---|
Provider Name | Stephanie Dalton |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Crestview Hills, KY 41017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 24/12/2018 |