Individual
MOMOKO SANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2281
Mailing address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2281
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01078537A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2014
Last updated
06/08/2018
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