Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | R75468 | AZ |
NPI | 1376907923 |
---|---|
Provider Name | Victor Laurion |
First Address | Tucson, AZ 85724-0001 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 11/04/2016 |