Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 4301094703 | MI |
N | 2080P0214X | Pediatric Pulmonologist | 9623579 | UT |
NPI | 1336371442 |
---|---|
Provider Name | Khalid Safi |
First Address | Millcreek, UT 84124-2500 |
Second Address | Millcreek, UT 84124-2500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2009 |
Last Update Date | 23/11/2021 |