Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 71716-20 | WI |
NPI | 1003290586 |
---|---|
Provider Name | Nawras Alshoubaki |
First Address | Oak Creek, WI 53154-2155 |
Second Address | Oak Creek, WI 53154-2155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2015 |
Last Update Date | 07/12/2021 |