Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD00037196 | WA |
NPI | 1043217920 |
---|---|
Provider Name | Peter S Kwon |
First Address | Tacoma, WA 98405-4682 |
Second Address | Tacoma, WA 98405-4682 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 05/04/2012 |