Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 4301106996 | MI |
NPI | 1053798843 |
---|---|
Provider Name | Dr. Siri Sahib Khalsa |
First Address | Ann Arbor, MI 48109-5000 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 30/04/2015 |