Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 2301009913 | MI |
NPI | 1538413745 |
---|---|
Provider Name | Dr. Mohammad Hazimi Hazimi |
First Address | Livonia, MI 48154-3811 |
Second Address | Livonia, MI 48154-3811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2012 |
Last Update Date | 09/11/2012 |