Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 64492-20 | WI |
NPI | 1134231293 |
---|---|
Provider Name | Jonathan Emerson Kohler |
First Address | Sacramento, CA 95817-2215 |
Second Address | Sacramento, CA 95817-2215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/12/2020 |