Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 19028 | NV |
NPI | 1033186796 |
---|---|
Provider Name | Peter Lloyd Hildebrand |
First Address | Henderson, NV 89012-5731 |
Second Address | Las Vegas, NV 89106-4145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 28/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033186796 | (05) | NV |
D90054 | (02) |