Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | DO1735 | NV |
N | 111NI0900X | Internist | DO1735 | NV |
N | 207RC0200X | Critical Care Medicine | DO1735 | NV |
Y | 207RP1001X | Pulmonary Disease | DO1735 | NV |
NPI | 1033430962 |
---|---|
Provider Name | Jerome Karl Hruska |
First Address | Las Vegas, NV 89180-1345 |
Second Address | Las Vegas, NV 89106-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2010 |
Last Update Date | 15/04/2020 |