Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101-237034 | VA |
Y | 2080P0210X | Pediatric Nephrologist | 0101-237034 | VA |
NPI | 1922087279 |
---|---|
Provider Name | Farahaba Lakhdir |
First Address | Roanoke, VA 24018-5276 |
Second Address | Roanoke, VA 24018-0720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2006 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010105668 | (05) | VA |
010149606 | (05) | VA |
G58560 | (02) | VA |