Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 34866 | OK |
NPI | 1316309164 |
---|---|
Provider Name | Meena Ezzat Guirguis |
First Address | Oklahoma City, OK 73104-5008 |
Second Address | Oklahoma City, OK 73104-5008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 06/06/2019 |