Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 8990 | NV |
NPI | 1053394148 |
---|---|
Provider Name | Dr. Larry F Cohler |
First Address | Las Vegas, NV 89170-1236 |
Second Address | Las Vegas, NV 89109-2298 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 02/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018109 | (05) | NV |
E86375 | (02) |