Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME70734 | FL |
NPI | 1154309771 |
---|---|
Provider Name | Kenneth A Konsker |
First Address | Boca Raton, FL 33431 |
Second Address | Boca Raton, FL 33431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G28102 | (02) |