Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 5708 | ND |
Y | 207KA0200X | Allergist | MD-46630 | IA |
NPI | 1528019767 |
---|---|
Provider Name | Danilo Dalan |
First Address | Waterloo, IA 50702-5634 |
Second Address | Waterloo, IA 50702-5634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 05/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17448 | (05) | ND |
357108 | (02) | ND |
5708 | NORTH DAKOTA LICENSE (01) | ND |