Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 414 | NV |
NPI | 1174976237 |
---|---|
Provider Name | Robin Roveri |
First Address | Las Vegas, NV 89146-2976 |
Second Address | Las Vegas, NV 89146-2976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2016 |
Last Update Date | 13/07/2016 |