Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 960 | NV |
NPI | 1134394075 |
---|---|
Provider Name | Dr. Victor Benjamin Klausner |
First Address | Las Vegas, NV 89106-3854 |
Second Address | Las Vegas, NV 89106-3854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 29/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08888 | (02) | NV |