Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5601009190 | MI |
NPI | 1033778626 |
---|---|
Provider Name | Joanne Sabra |
First Address | Troy, MI 48083-2015 |
Second Address | Troy, MI 48083-2015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2019 |
Last Update Date | 25/08/2020 |