NPI | 1740280072 |
---|---|
Other Name | JONATHAN KALE GAVIN SHUMATE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD154161) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA MD.200122) |
207V00000X Obstetrics & Gynecology (Licence: WA MD00047503) | |
Enumeration Date | 2005-07-28 |
Last Update Date | 2020-10-29 |