Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 10255 | NV |
NPI | 1326078098 |
---|---|
Provider Name | Dr. Alfreda I. Maller |
First Address | Las Vegas, NV 89109-3211 |
Second Address | Las Vegas, NV 89109-3211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018705 | (05) | NV |
G40033 | (02) | NV |