Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 19544 | IA |
NPI | 1013189885 |
---|---|
Provider Name | Dr. Paul Robert Gregory |
First Address | Sioux City, IA 51108-8644 |
Second Address | Sioux City, IA 51108-8644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 01/04/2008 |