NPI | 1194221358 |
---|---|
Former Name | JOSEPH BRANT FENNER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 65834) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29141) |
207R00000X Internal Medicine (Licence: MN 65834) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: IA R-12360) | |
Enumeration Date | 2018-04-04 |
Last Update Date | 2023-02-22 |