Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 4351037762 | MI |
NPI | 1023539913 |
---|---|
Provider Name | Dr. Yasir M M Farah |
First Address | Farmington Hills, MI 48336-2817 |
Second Address | Livonia, MI 48152-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2017 |
Last Update Date | 30/06/2020 |