Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 45339 | IA |
Y | 207RP1001X | Pulmonary Disease | 45339 | IA |
NPI | 1073827721 |
---|---|
Provider Name | Dr. Braden Christopher Powers |
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 | 04/08/2010 |
Last Update Date | 21/01/2019 |