Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2901021126 | MI |
NPI | 1003239856 |
---|---|
Provider Name | Dr. Rana Adel Rabban |
First Address | Southfield, MI 48034-5693 |
Second Address | Southfield, MI 48034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2014 |
Last Update Date | 31/10/2016 |