Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN002212 | NV |
NPI | 1003262296 |
---|---|
Provider Name | Aric Pedro Adaoag |
First Address | Las Vegas, NV 89183-7603 |
Second Address | Las Vegas, NV 89183-7603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2016 |
Last Update Date | 06/05/2016 |