Individual
KASHIF RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3516 BECA FAITH DR, NORTH LAS VEGAS, NV 89032-7903
(702) 624-6515
Mailing address
3516 BECA FAITH DR, NORTH LAS VEGAS, NV 89032-7903
(702) 624-6515
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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