Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 43086 | IA |
NPI | 1033221916 |
---|---|
Provider Name | Dr. Adrian Grant Letz |
First Address | Dubuque, IA 52001-6320 |
Second Address | Dubuque, IA 52001-6320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 06/04/2021 |