Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2017003085 | MO |
N | 2080P0214X | Pediatric Pulmonologist | A128325 | CA |
NPI | 1093003600 |
---|---|
Provider Name | Dr. Nadine Mokhallati |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2011 |
Last Update Date | 14/07/2017 |