Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD044299 | DC |
N | 111NI0900X | Internist | MD044299 | DC |
Y | 207RC0200X | Critical Care Medicine | 18922 | NV |
N | 207RP1001X | Pulmonary Disease | 18922 | NV |
NPI | 1053653576 |
---|---|
Provider Name | Choua Thao |
First Address | Reno, NV 89502-1576 |
Second Address | Reno, NV 89502-1576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 08/12/2021 |