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A pediatrician who has special qualifications to manage emergencies in infants and children.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Emergency Medicine |
2080P0204X | 37 | Physician/Pediatric Medicine |
| NPI Number | 1912282831 |
| LBN Legal business name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
| Authorized official | JEFFREY LIMBOCKER - (CFO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/12/2011 |
| Last updated | 10/12/2011 - About 15 years ago |
| Identifiers | n/a |
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OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
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