Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 99816 | NV |
NPI | 1700854122 |
---|---|
Provider Name | Robert James Troell |
First Address | Las Vegas, NV 89117-7916 |
Second Address | Las Vegas, NV 89117-7916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 26/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87687 | (02) | NV |