Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 9172 | NV |
NPI | 1053367383 |
---|---|
Provider Name | Dr. Brian Jonathan Lipman |
First Address | Los Angeles, CA 90084-5712 |
Second Address | Henderson, NV 89052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 04/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2018176 | (05) | NV |
E44639 | (02) |