Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 04-37591 | KS |
Y | 207ND0900X | Dermatopathologist | 04-37591 | KS |
NPI | 1619297769 |
---|---|
Provider Name | Brandon Litzner |
First Address | Salina, KS 67401-7406 |
Second Address | Wichita, KS 67206-1264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2010 |
Last Update Date | 22/05/2020 |