Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 18039 | NE |
NPI | 1255413803 |
---|---|
Provider Name | Mr. Nirmal Arogyaswami Raj |
First Address | Omaha, NE 68127-1745 |
Second Address | Omaha, NE 68127-1745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F06952 | (02) | NE |