Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301060576 | MI |
NPI | 1093763153 |
---|---|
Provider Name | Dr. Anna Teresa Dobracki |
First Address | Brighton, MI 48116-2326 |
Second Address | Brighton, MI 48116-2326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093763153 | (05) | MI |