Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 23189 | NE |
NPI | 1295790517 |
---|---|
Provider Name | Donald Harrison |
First Address | Omaha, NE 68144-2336 |
Second Address | Omaha, NE 68144-2336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D45584 | (02) | NE |