Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 4301102073 | MI |
NPI | 1194168948 |
---|---|
Provider Name | Doris Rafic Taha |
First Address | Detroit, MI 48201-2153 |
Second Address | Detroit, MI 48201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 13/01/2017 |