Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 6825 | NV |
NPI | 1053314708 |
---|---|
Provider Name | Dan E Rowe |
First Address | Reno, NV 89509-4857 |
Second Address | Reno, NV 89509-4857 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 17/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2016685 | (05) | NV |
F23380 | (02) | NV |