Individual
DANE VAN TASSEL
Active
Individual
DANE VAN TASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R73452
AZ
2085P0229X
Pediatric Radiology Physician
Primary
48187
AZ
2085R0202X
Diagnostic Radiology Physician
48187
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R73452
TRAINING PERMIT
AZ
Enumeration date
06/08/2012
Last updated
09/06/2018
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