Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 303051-01 | NY |
Y | 204F00000X | Transplant Surgeon | 35.142710 | OH |
NPI | 1396107264 |
---|---|
Provider Name | Suzanne Elizabeth Evans |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45229-3019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 30/06/2021 |