Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20008 | NV |
NPI | 1003347295 |
---|---|
Provider Name | Nittu Singh |
First Address | Las Vegas, NV 89193-8978 |
Second Address | Las Vegas, NV 89149-3923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2017 |
Last Update Date | 27/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003347295 | (05) | NV |
20008 | STATE LICENSE (01) | NV |