Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 14941 | WI |
NPI | 1003861048 |
---|---|
Provider Name | Eugene P Sinclair |
First Address | Milwaukee, WI 53223 |
Second Address | Glendale, WI 53212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 27/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30894700 | (05) | WI |
B56634 | (02) |