Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 37464 | IA |
Y | 111NI0900X | Internist | 37464 | IA |
NPI | 1003082546 |
---|---|
Provider Name | Paul Franke |
First Address | Waterloo, IA 50702-5401 |
Second Address | Waterloo, IA 50702-5401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 05/05/2008 |