Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 15974 | NV |
NPI | 1013236405 |
---|---|
Provider Name | Luis Humberto Medina-Garcia |
First Address | Las Vegas, NV 89102 |
Second Address | Las Vegas, NV 89102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2010 |
Last Update Date | 24/10/2018 |