Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 04-14549 | KS |
NPI | 1770888471 |
---|---|
Provider Name | John Rempel |
First Address | Wichita, KS 67206-1118 |
Second Address | Wichita, KS 67206-1118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2011 |
Last Update Date | 11/01/2011 |