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 |