Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 5714677-1205 | UT |
NPI | 1043264070 |
---|---|
Provider Name | Dr. Daniel V Kinikini |
First Address | Salt Lake City, UT 84141-3035 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 09/12/2013 |