Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003211434 |
---|---|
Provider Name | Yoslani Guerra |
First Address | Las Vegas, NV 89121-4262 |
Second Address | Las Vegas, NV 89121-4262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2014 |
Last Update Date | 28/10/2014 |