Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 5101024649 | MI |
NPI | 1083062087 |
---|---|
Provider Name | Sabrina Huq |
First Address | Grand Rapids, MI 49503-2559 |
Second Address | Grand Rapids, MI 49503-2560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2016 |
Last Update Date | 14/12/2021 |