Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 15508 | KS |
NPI | 1114955911 |
---|---|
Provider Name | Dr. Paul Stein |
First Address | Wichita, KS 67206-3307 |
Second Address | Wichita, KS 67206-3920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |