Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 38271 | GA |
NPI | 1093884355 |
---|---|
Provider Name | Dr. Aijaz A Khalid |
First Address | Lawrenceville, GA 30045-7418 |
Second Address | Lawrenceville, GA 30045-7418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |