Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0429718 | KS |
NPI | 1104813419 |
---|---|
Provider Name | Dr. Khaled R Girgis |
First Address | Atlanta, GA 30374-1331 |
Second Address | Overland Park, KS 66210-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 04/01/2022 |