Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 23878 | OK |
NPI | 1003858663 |
---|---|
Provider Name | Viorica Khalili |
First Address | Edmond, OK 73034-6399 |
Second Address | Edmond, OK 73034-6399 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I07327 | (02) | OK |
MEDICAL LICENSE | 23878 (01) | OK |