Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 48773 | KY |
N | 207RP1001X | Pulmonary Disease | 48773 | KY |
NPI | 1003122441 |
---|---|
Provider Name | Abdel Rahman Lataifeh |
First Address | Pikeville, KY 41502-0432 |
Second Address | Pikeville, KY 41501-1689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2010 |
Last Update Date | 23/03/2016 |