| NPI | 1760055578 |
|---|---|
| Other Name | JAMISON CLYDE DAVID UTZIG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81756-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 8828-851) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-12-02 |