Individual
NIDA E BONUEL
Active
Individual
NIDA E BONUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7502
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760440200
—
NV
01
—
7502
STATE LICENSE
NV
01
—
P00367728
RAIL ROAD MEDICARE
NV
Enumeration date
05/03/2006
Last updated
10/17/2022
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