Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A62143 | CA |
NPI | 1023234812 |
---|---|
Provider Name | Iglal El Henawi |
First Address | Hemet, CA 92545-5279 |
Second Address | Hemet, CA 92545-5279 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 05/12/2011 |