Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | S4-99 | NV |
NPI | 1043510399 |
---|---|
Provider Name | Dr. Aaron G Radmall |
First Address | Henderson, NV 89015 |
Second Address | Henderson, NV 89015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2010 |
Last Update Date | 04/01/2017 |