Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 9674 | SD |
NPI | 1497080873 |
---|---|
Provider Name | Amit Jain |
First Address | Sioux Falls, SD 57105-1521 |
Second Address | Sioux Falls, SD 57105-1521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2009 |
Last Update Date | 28/07/2016 |