Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 4301092413 | MI |
N | 208000000X | Pediatrician | 49565 | WI |
NPI | 1053456723 |
---|---|
Provider Name | Rahul Kaila |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201-2119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 16/06/2009 |