Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | A421298622091 | MI |
NPI | 1235731803 |
---|---|
Provider Name | Hanin N Al-Jaber I |
First Address | Dearborn Heights, MI 48125-3313 |
Second Address | Dearborn Heights, MI 48125-3313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2020 |
Last Update Date | 09/11/2020 |