Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 12-00434 | KS |
N | 213EP1101X | Primary Podiatric Medicine | SC006451 | PA |
NPI | 1043647795 |
---|---|
Provider Name | Aiman Nguib Milad Bishara |
First Address | Wichita, KS 67214-2810 |
Second Address | Wichita, KS 67214-2810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2013 |
Last Update Date | 06/07/2017 |