| NPI | 1033287347 |
|---|---|
| Professional Name | JACK L. BRENNER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 106478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 106478) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2012-09-19 |