Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 4262 | WV |
NPI | 1285161547 |
---|---|
Provider Name | Hiba Qari |
First Address | Morgantown, WV 26505-3867 |
Second Address | Morgantown, WV 26506-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2017 |
Last Update Date | 17/05/2017 |