Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 85005 | GA |
NPI | 1003259045 |
---|---|
Provider Name | Maria Diab |
First Address | Detroit, MI 48201-2153 |
Second Address | Detroit, MI 48201-2153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 27/08/2020 |