Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 7468 | KS |
NPI | 1003137589 |
---|---|
Provider Name | Patrick Bowen |
First Address | Wichita, KS 67214 |
Second Address | Wichita, KS 67214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 18/06/2010 |