Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD183199 | OR |
N | 111NI0900X | Internist | MD183199 | OR |
NPI | 1003221409 |
---|---|
Provider Name | Raeesa Khalid |
First Address | Hillsboro, OR 97123-4246 |
Second Address | Hillsboro, OR 97123-4246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 23/01/2019 |