Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 12309 | NV |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 12309 | NV |
NPI | 1033218839 |
---|---|
Provider Name | Dr. Daejoon Anh |
First Address | Las Vegas, NV 89193-8978 |
Second Address | Las Vegas, NV 89109-2578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 28/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033218839 | (05) | NV |