Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 15366 | NV |
Y | 2080P0208X | Pediatric Infectious Diseases | 15366 | NV |
NPI | 1265688105 |
---|---|
Provider Name | Dr. Rita Ghutai Shah |
First Address | Las Vegas, NV 89106-4195 |
Second Address | Las Vegas, NV 89106-4195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 06/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265688105 | (05) | NV |