Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0600X | Clinical Neurophysiologist | 38971 | IA |
NPI | 1427251768 |
---|---|
Provider Name | Weeraworn Nakarawat |
First Address | Des Moines, IA 50309-1423 |
Second Address | Des Moines, IA 50309-1423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1427251768 | (05) | IA |