NPI | 1336501022 |
---|---|
Former Name | BENNETT ZUKEL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60927879) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-03-22 |
Last Update Date | 2021-05-18 |