Individual
HERODINA IBANEZ LU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 ELIZABETH PL STE 100, DAYTON, OH 45417-3445
(937) 723-7230
Mailing address
960 HEATHSHIRE DR, CENTERVILLE, OH 45459-2320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005687RX
OH
Other
Enumeration date
01/25/2019
Last updated
05/08/2024
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