Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 42246 | WI |
NPI | 1043658412 |
---|---|
Provider Name | Abdul Munem Kenj Halabi |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 13/01/2021 |