Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 35123608 | OH |
NPI | 1265611297 |
---|---|
Provider Name | Daniel E Vazquez |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 24/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0108970 | (05) | OH |