Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 35.059786 | OH |
NPI | 1225025638 |
---|---|
Provider Name | Susan Ann Brown |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 15/11/2007 |