Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 6165 | KS |
NPI | 1013133735 |
---|---|
Provider Name | Valerie Audra Grau |
First Address | Wichita, KS 67214-3124 |
Second Address | Wichita, KS 67214-3124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 18/03/2008 |