| NPI | 1568462992 |
|---|---|
| Former Name | KENNETH LAWRENCE BUTLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 106989) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0423290) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2021-12-14 |