Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 20836 | NV |
N | 207X00000X | Orthopaedic Surgeon | BP10053948 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 60844 | AZ |
NPI | 1154709491 |
---|---|
Provider Name | Angelina Maria Vera |
First Address | Henderson, NV 89052-4186 |
Second Address | Henderson, NV 89052-4186 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2015 |
Last Update Date | 16/11/2021 |