Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 21269 | NE |
NPI | 1063477834 |
---|---|
Provider Name | Dr. Rudolf J Kotula |
First Address | Omaha, NE 68103-0755 |
Second Address | Omaha, NE 68114-3732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 03/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
099099032 | (02) | NE |
1063477834 | (05) | IA |
47068731742 | (05) | NE |