Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 31118 | NE |
N | 207L00000X | Anesthesiologist | A84514 | CA |
NPI | 1003393703 |
---|---|
Provider Name | Adetinuwe Majekodunmi |
First Address | Lincoln, NE 68503-3610 |
Second Address | Kearney, NE 68847-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2018 |
Last Update Date | 15/10/2018 |