Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301115340 | MI |
Y | 111NI0900X | Internist | 4301115340 | MI |
NPI | 1003307091 |
---|---|
Provider Name | Hajira Younas Khan |
First Address | Pontiac, MI 48341-5023 |
Second Address | Pontiac, MI 48341-5023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2018 |
Last Update Date | 24/05/2018 |