Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 7859 | NV |
NPI | 1235108325 |
---|---|
Provider Name | Sina Nasri-Chenijani |
First Address | Las Vegas, NV 89109 |
Second Address | Las Vegas, NV 89128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 11/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002019825 | (05) | NV |
F99575 | (02) |