Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 5151014586 | MI |
Y | 111NI0900X | Internist | 5151014586 | MI |
NPI | 1003439852 |
---|---|
Provider Name | Kali Allis |
First Address | Farmington Hills, MI 48336-5919 |
Second Address | Farmington Hills, MI 48336-5919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2020 |
Last Update Date | 27/05/2020 |