NPI | 1992763411 |
---|---|
Other Name | T STEVEN IVAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-50713) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4082) |
Enumeration Date | 2006-05-03 |
Last Update Date | 2025-04-10 |