Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 04-34673 | KS |
NPI | 1386819738 |
---|---|
Provider Name | Iram Sirajuddin |
First Address | Wichita, KS 67208-3052 |
Second Address | Wichita, KS 67208-3052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 21/07/2011 |