Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G79141 | CA |
N | 2084N0600X | Clinical Neurophysiologist | G79141 | CA |
NPI | 1306898937 |
---|---|
Provider Name | Kevin D Graber |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 28/12/2021 |