Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 69204 | WI |
NPI | 1578827234 |
---|---|
Provider Name | Abdul Latif Bikak |
First Address | Shreveport, LA 71101-3910 |
Second Address | Shreveport, LA 71103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2012 |
Last Update Date | 18/06/2021 |