Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1083199475 |
---|---|
Provider Name | Julyana Hakim |
First Address | Sterling Heights, MI 48312-6392 |
Second Address | Sterling Heights, MI 48312-6392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2018 |
Last Update Date | 01/10/2018 |