| NPI | 1427249564 |
|---|---|
| Other Name | KIRK JON BLANCAS-TIEMANN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M9059) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10021976) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2023-10-19 |