Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | Q3864 | TX |
NPI | 1164736955 |
---|---|
Provider Name | Khaled Ali B Sherif |
First Address | Lubbock, TX 79410-1203 |
Second Address | Lubbock, TX 79410-1203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2010 |
Last Update Date | 10/06/2016 |