Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 1879 | NE |
NPI | 1790142412 |
---|---|
Provider Name | Dr. Andrew Brugman I |
First Address | Fullerton, NE 68638-0088 |
Second Address | Fullerton, NE 68638-0088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2016 |
Last Update Date | 26/01/2016 |