Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 5151009508 | MI |
NPI | 1033607791 |
---|---|
Provider Name | Joshua Nass |
First Address | Farmington Hills, MI 48336-5919 |
Second Address | Farmington Hills, MI 48336-5919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2018 |
Last Update Date | 23/01/2019 |