NPI | 1326034117 |
---|---|
Former Name | JERRY J JOGERST |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 20750) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IA 20750) |
Enumeration Date | 2005-09-27 |
Last Update Date | 2008-02-05 |