Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301103956 | MI |
N | 111NI0900X | Internist | 4301103956 | MI |
Y | 207R00000X | Internist | 464135 | PA |
Y | 111NI0900X | Internist | 464135 | PA |
N | 208000000X | Pediatrician | 464135 | PA |
NPI | 1003174202 |
---|---|
Provider Name | Allie Dakroub |
First Address | Pittsburgh, PA 15213 |
Second Address | Pittsburgh, PA 15213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2012 |
Last Update Date | 25/08/2021 |