Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 13377 | NE |
NPI | 1104930932 |
---|---|
Provider Name | Dr. Againdra K Bewtra |
First Address | Omaha, NE 68178-0001 |
Second Address | Omaha, NE 68131-2137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 28/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B90775 | (02) | NE |