Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 000794 | NV |
NPI | 1023355179 |
---|---|
Provider Name | Lori O'toole |
First Address | Henderson, NV 89074-5954 |
Second Address | Las Vegas, NV 89128-0443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2013 |
Last Update Date | 09/01/2013 |