Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101015734 | MI |
NPI | 1346450558 |
---|---|
Provider Name | Dr. Ayman D Yaish |
First Address | Beaver Dam, WI 53916 |
Second Address | Beaver Dam, WI 53916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/03/2010 |