Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 4704316053 | MI |
NPI | 1013671916 |
---|---|
Provider Name | Ibtihal Alghanimi |
First Address | Dearborn, MI 48126-1066 |
Second Address | Dearborn, MI 48126-2287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2021 |
Last Update Date | 26/10/2021 |