Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.246883 | OH |
NPI | 1023679271 |
---|---|
Provider Name | Gustavo Guimaraes Rangel |
First Address | Dublin, OH 43017-1001 |
Second Address | Dublin, OH 43017-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2019 |
Last Update Date | 27/06/2019 |