Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 14418 | NV |
NPI | 1255619177 |
---|---|
Provider Name | Holman Chan |
First Address | Las Vegas, NV 89128-4356 |
Second Address | Henderson, NV 89074-8194 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2011 |
Last Update Date | 18/01/2016 |