Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 17690 | NV |
N | 2080P0210X | Pediatric Nephrologist | 20815 | AZ |
NPI | 1750490918 |
---|---|
Provider Name | Elie Salim Firzli |
First Address | Reno, NV 89502-2055 |
Second Address | Reno, NV 89502-1469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 23/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12010036 | CAQH (01) | |
F69299 | (02) | AZ |