Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD-48324 | IA |
Y | 207RI0011X | Interventional Cardiology | MD-48324 | IA |
NPI | 1124434360 |
---|---|
Provider Name | Khalil Anouti |
First Address | Waterloo, IA 50704-2758 |
Second Address | Waterloo, IA 50703-1500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 02/07/2021 |