| NPI | 1235855792 |
|---|---|
| Professional Name | LEVI DOUGLAS OTIS BARNUM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY PA1037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY PA1037) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2023-02-23 |