Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 812325 | NV |
N | 363LA2200X | Nurse Practitioner - Adult Health | 20534 | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 20534 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 20534 | CA |
NPI | 1043509490 |
---|---|
Provider Name | Mr. Ferdinand Limtao |
First Address | Las Vegas, NV 89102 |
Second Address | Henderson, NV 89014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 19/10/2018 |