Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 10654 | MT |
N | 207RP1001X | Pulmonary Disease | 10654 | MT |
Y | 207RS0012X | Sleep Medicine | 10654 | MT |
NPI | 1013963958 |
---|---|
Provider Name | Rolf H O Holle |
First Address | Missoula, MT 59802-3684 |
Second Address | Missoula, MT 59802-3684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 02/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0082280 | (05) | MT |
A09297 | (02) |