Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 9113 | NV |
NPI | 1346354750 |
---|---|
Provider Name | Dr. Jeffrey Fisch |
First Address | Las Vegas, NV 89118-1840 |
Second Address | Las Vegas, NV 89109-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 14/04/2008 |