Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 35.064894 | OH |
Y | 207RG0100X | Gastroenterologist | 7692 | NV |
NPI | 1023017696 |
---|---|
Provider Name | Laura G Gitlin |
First Address | Las Vegas, NV 89128-3157 |
Second Address | Las Vegas, NV 89128-3157 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F13101 | (02) |