Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 6247 | NV |
NPI | 1083687347 |
---|---|
Provider Name | Mr. Joseph P Brandl |
First Address | Reno, NV 89502-2055 |
Second Address | Reno, NV 89502-1198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 01/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002016493 | (05) | NV |
E50384 | (02) |