Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 4301089591 | MI |
N | 2080P0201X | Pediatric Allergist | 4301089591 | MI |
NPI | 1750571675 |
---|---|
Provider Name | Fatima B Hassan |
First Address | Monroe, MI 48162-3113 |
Second Address | Monroe, MI 48162-3113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 09/10/2018 |