Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 80761 | AZ |
N | 207T00000X | Neurosurgeon | A 125065 | CA |
Y | 207T00000X | Neurosurgeon | E-8674 | AR |
NPI | 1093995136 |
---|---|
Provider Name | Adib Adnan Abla |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2007 |
Last Update Date | 14/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80761 | TRAINING PERMIT (01) | AZ |