NPI | 1861410730 |
---|---|
Other Name | CHET LELWYNN GREGORY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 202699) |
Additional Taxonomies | 152W00000X Optometrist (Licence: LA 765-002T) |
207P00000X Emergency Medicine (Licence: LA 202699) | |
Enumeration Date | 2006-07-18 |
Last Update Date | 2019-12-03 |