Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 070994 | MI |
NPI | 1114907912 |
---|---|
Provider Name | Dr. Rafia Khalil |
First Address | Port Huron, MI 48060-3563 |
Second Address | Port Huron, MI 48060-3563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 27/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H82562 | (02) | MI |