Individual
MR. FABIO KAZUO DANTAS HIGUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13974 S 2700 W, BLUFFDALE, UT 84065-5403
(801) 403-7600
Mailing address
13974 S 2700 W, BLUFFDALE, UT 84065-5403
(801) 403-7600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001230559
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169858
VA
Other
Enumeration date
02/03/2012
Last updated
11/04/2021
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