Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 19346 | NV |
N | 207RP1001X | Pulmonary Disease | 19346 | NV |
NPI | 1093157836 |
---|---|
Provider Name | Dr. Karan Gupta |
First Address | Las Vegas, NV 89148-5613 |
Second Address | Las Vegas, NV 89148-5613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2013 |
Last Update Date | 11/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19346 | NV MEDICAL LICENSE (01) | NV |