Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 13577 | NV |
N | 207YS0123X | Facial Plastic Surgeon | 13577 | NV |
NPI | 1144470048 |
---|---|
Provider Name | Jeannie Khavkin |
First Address | Las Vegas, NV 89144-0520 |
Second Address | Las Vegas, NV 89144-0517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2008 |
Last Update Date | 04/11/2019 |