Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 18470 | NV |
NPI | 1316232275 |
---|---|
Provider Name | Dr. Sathyaseelan Subramaniam |
First Address | Las Vegas, NV 89107-1084 |
Second Address | Las Vegas, NV 89107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 01/07/2019 |