Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 14368 | CO |
NPI | 1013908151 |
---|---|
Provider Name | Dr. Klaus Dieter Rennert |
First Address | Aiea, HI 96701-1861 |
Second Address | Pearl Harbor, HI 96860-4908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 08/07/2007 |