| NPI | 1568512101 |
|---|---|
| Professional Name | GARY MAX DESHAZO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 380) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: NV 380) |
| 261QC1500X Clinic/Center Community Health (Licence: NV 380) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2022-02-17 |