Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 2010010425 | MO |
Y | 2080P0210X | Pediatric Nephrologist | 54175 | AZ |
NPI | 1912210907 |
---|---|
Provider Name | Dr. Shwetal Lalan |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85006-1462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2010 |
Last Update Date | 23/03/2018 |