Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 69540 | MN |
NPI | 1154740520 |
---|---|
Provider Name | Dr. Vinod Valentine |
First Address | Augusta, GA 30904-7149 |
Second Address | El Paso, TX 79905-2709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 30/07/2021 |