Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 13798 | NE |
NPI | 1093160368 |
---|---|
Provider Name | Lee Newcomer |
First Address | Minnetonka, MN 55345-2900 |
Second Address | Minnetonka, MN 55345-2900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2016 |
Last Update Date | 25/04/2016 |