Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 1003263476 | MI |
NPI | 1003263476 |
---|---|
Provider Name | Dr. Ali I Sobh |
First Address | Dearborn, MI 48126-1442 |
Second Address | Dearborn, MI 48126-1442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2016 |
Last Update Date | 30/03/2020 |