Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN002865 | NV |
NPI | 1003303991 |
---|---|
Provider Name | Mr. Daniel Garrido Arsulo |
First Address | Las Vegas, NV 89166-6557 |
Second Address | Las Vegas, NV 89101-2885 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 17/04/2018 |