Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 036139173 | IL |
Y | 2080P0203X | Pediatric Critical Care Doctor | 04-40316 | KS |
NPI | 1255631867 |
---|---|
Provider Name | Hammad Ashraf Ganatra |
First Address | Kansas City, KS 66160-0001 |
Second Address | Kansas City, KS 66160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2010 |
Last Update Date | 23/03/2019 |