Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 9717129-1205 | UT |
N | 207R00000X | Internist | MD.201983 | LA |
N | 111NI0900X | Internist | MD.201983 | LA |
N | 208000000X | Pediatrician | MD.201983 | LA |
NPI | 1306027842 |
---|---|
Provider Name | Aaron Kobernick |
First Address | Chinle, AZ 86503 |
Second Address | Salt Lake City, UT 84132-2632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2007 |
Last Update Date | 03/11/2021 |