Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 94-09470 | KS |
Y | 111NI0900X | Internist | 94-09470 | KS |
NPI | 1003309766 |
---|---|
Provider Name | Karl Hamouche |
First Address | Wichita, KS 67214-3124 |
Second Address | Wichita, KS 67214-3124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2018 |
Last Update Date | 07/06/2018 |