Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | MD2018-0631 | NM |
NPI | 1346213691 |
---|---|
Provider Name | Dr. Henry Wojtczak |
First Address | Poway, CA 92064 |
Second Address | Albuquerque, NM 87131-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 05/02/2019 |