Individual
MS. KEKELI DIANE OMINIRA AMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1535 ELKTON PL, CINCINNATI, OH 45224-2517
(513) 919-6463
Mailing address
PO BOX 2669, NEW YORK, NY 10163-2669
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025399
NY
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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