Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 74583-20 | WI |
NPI | 1700550514 |
---|---|
Provider Name | Dr. Elie Khalifee |
First Address | Milwaukee, WI 53226-3067 |
Second Address | Milwaukee, WI 53226-3067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2021 |
Last Update Date | 22/11/2021 |