Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 9820 | NV |
NPI | 1023065422 |
---|---|
Provider Name | Kathleen Wairimu |
First Address | Las Vegas, NV 89133-4686 |
Second Address | Las Vegas, NV 89129-7424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018464 | (05) | NV |
H60836 | (02) | NV |