Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist |
NPI | 1679194310 |
---|---|
Provider Name | Bayan Salameh |
First Address | Texarkana, AR 71854-2536 |
Second Address | Hope, AR 71801-9666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2020 |
Last Update Date | 05/05/2020 |