Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A123581 | CA |
Y | 2080P0214X | Pediatric Pulmonologist | A123581 | CA |
NPI | 1295026862 |
---|---|
Provider Name | Rory John Kamerman-Kretzmer |
First Address | Sacramento, CA 95817-2208 |
Second Address | Sacramento, CA 95817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2011 |
Last Update Date | 23/08/2018 |