Individual
WYNN-C KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 TULANE AVE, NEW ORLEANS, LA 70112
(504) 702-2287
Mailing address
2905 3RD AVE SE, ABERDEEN, SD 57401-5420
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12160
SD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2016
Last updated
01/05/2021
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