Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | T2868 | TX |
N | 111NI0900X | Internist | T2868 | TX |
N | 207RG0100X | Gastroenterologist | 56254 | WI |
N | 207RG0100X | Gastroenterologist | T2868 | TX |
NPI | 1023320637 |
---|---|
Provider Name | Aiman Ghufran |
First Address | San Antonio, TX 78229-3707 |
Second Address | San Antonio, TX 78229-3707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2010 |
Last Update Date | 08/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023320637 | (05) | WI |