| NPI | 1215988282 |
|---|---|
| Former Name | JASON WAYNE RUNDELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-30969) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME 04-30969) |
| 207Q00000X Family Medicine (Licence: KS 04-30969) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-12-02 |