Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 5101010695 | MI |
NPI | 1205866480 |
---|---|
Provider Name | Rahmon Zuckerman |
First Address | Monroe, MI 48161-0964 |
Second Address | Monroe, MI 48162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 03/11/2008 |