Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 0105954 | KS |
NPI | 1467011338 |
---|---|
Provider Name | Hira Fatima Khan |
First Address | Overland Park, KS 66213-1731 |
Second Address | Lawrence, KS 66049-9809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2019 |
Last Update Date | 13/06/2019 |