Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 7874 | NE |
NPI | 1316486897 |
---|---|
Provider Name | Oluwatobi Ogun |
First Address | Omaha, NE 68198-3285 |
Second Address | Omaha, NE 68198-3285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2017 |
Last Update Date | 17/02/2017 |