Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 8628 | NV |
NPI | 1083613616 |
---|---|
Provider Name | Lynn D Kowalski |
First Address | Henderson, NV 89016-0634 |
Second Address | Las Vegas, NV 89118-2656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 13/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018009 | (05) | NV |
F89854 | (02) |