Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901004737 | MI |
NPI | 1013267830 |
---|---|
Provider Name | Dr. Alpa M. Desai |
First Address | Canton, MI 48187-2914 |
Second Address | Northville, MI 48168-9802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 26/08/2015 |