Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 04-40765 | KS |
NPI | 1548504541 |
---|---|
Provider Name | Mohammed Farhan Ali |
First Address | Kansas City, MO 64108-4619 |
Second Address | Wichita, KS 67208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2012 |
Last Update Date | 26/06/2018 |