Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 2086S0102X | NY |
NPI | 1306512579 |
---|---|
Provider Name | Guillaume Daoust-Lafond |
First Address | White Plains, NY 10606-2361 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2021 |
Last Update Date | 18/08/2021 |