Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 16946 | NV |
NPI | 1124462056 |
---|---|
Provider Name | Grant Miki Karno |
First Address | Las Vegas, NV 89102-1998 |
Second Address | Las Vegas, NV 89148-4845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2013 |
Last Update Date | 08/11/2021 |