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Individual
DANIEL N GWAN-NULLA
Active
Individual
DANIEL N GWAN-NULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
208600000X
PA
208600000X
Surgery Physician
2009014868
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
080790
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2009-01579
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2009014868
MO
Other
Enumeration date
07/26/2005
Last updated
12/19/2018
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