| NPI | 1851621536 | 
|---|---|
| Former Name | VICTOR KLINGSHIRN | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9221773)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005933)  | 
| Enumeration Date | 2010-01-03 | 
| Last Update Date | 2022-10-03 |