| NPI | 1124598198 |
|---|---|
| Other Name | KYLE LOREN GULBRANSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 11055189-1205) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2018-12-03 |