Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 12641 | NV |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 131486 | NY |
NPI | 1083785174 |
---|---|
Provider Name | Dr. Evan Mitchell Klass |
First Address | Reno, NV 89503-5345 |
Second Address | Reno, NV 89557-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 29/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B17748 | (02) | NV |