Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 13585 | NV |
NPI | 1013155134 |
---|---|
Provider Name | Dr. Dominic F Martinez |
First Address | Las Vegas, NV 89108-4578 |
Second Address | Las Vegas, NV 89128-9028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2009 |
Last Update Date | 12/08/2020 |