Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | 1703836684 | NV |
NPI | 1023434032 |
---|---|
Provider Name | Celeste Gil |
First Address | Las Vegas, NV 89119 |
Second Address | Las Vegas, NV 89119-4687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2014 |
Last Update Date | 14/03/2014 |