Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 40107 | IA |
N | 207U00000X | Nuclear Medicine Specialist | 56046 | WI |
NPI | 1326266867 |
---|---|
Provider Name | Dr. Eric Michael Jakubowski |
First Address | Milwaukee, WI 53220-4608 |
Second Address | Milwaukee, WI 53220-4608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2007 |
Last Update Date | 09/01/2017 |