Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 7554 | NV |
NPI | 1528475340 |
---|---|
Provider Name | Ragini Fredrich |
First Address | Las Vegas, NV 89135 |
Second Address | Las Vegas, NV 89135-1539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2014 |
Last Update Date | 14/07/2014 |