Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | CH11740 | FL |
Y | 111NN0400X | Neurology | CHIR009377 | GA |
NPI | 1124416599 |
---|---|
Provider Name | David Traster |
First Address | Delray Beach, FL 33446-9556 |
Second Address | Delray Beach, FL 33446-9556 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2015 |
Last Update Date | 20/10/2016 |