Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301072526 | MI |
NPI | 1124085436 |
---|---|
Provider Name | Malathi Bathija |
First Address | Novi, MI 48377-2644 |
Second Address | Novi, MI 48377-2644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y46439 | (02) | MI |