Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 35.133846 | OH |
NPI | 1023425899 |
---|---|
Provider Name | Rafif Mousa |
First Address | Fairview Park, OH 44126-3302 |
Second Address | Fairview Park, OH 44126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2014 |
Last Update Date | 17/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0116027444 | STATE OF VIRGINIA MEDICAL LICENSE (01) | VA |