Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 25MA09124600 | NJ |
Y | 208000000X | Pediatrician | 307581 | LA |
NPI | 1093031114 |
---|---|
Provider Name | Jaime Rodrigo Morataya Mejia |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 12/12/2017 |