Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | A104110 | CA |
NPI | 1063690808 |
---|---|
Provider Name | Dr. Tim E. Darsaut |
First Address | Palo Alto, CA 94304-2333 |
Second Address | Palo Alto, CA 94304-2333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2008 |
Last Update Date | 13/06/2008 |