Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 687 | NE |
NPI | 1073615209 |
---|---|
Provider Name | Clayton Jepsen Hoberman |
First Address | Omaha, NE 68154-4423 |
Second Address | Omaha, NE 68154-4423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 01/07/2021 |