Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | B-916 | NV |
NPI | 1831307347 |
---|---|
Provider Name | Dr. Joseph Robert Nicola |
First Address | Las Vegas, NV 89117-2760 |
Second Address | Las Vegas, NV 89117-2760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 28/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U91056 | (02) | NE |