Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 220452 | MI |
NPI | 1164932489 |
---|---|
Provider Name | Salim Rufo Auraha |
First Address | Sterling Heights, MI 48310-5358 |
Second Address | Sterling Heights, MI 48310-5358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2017 |
Last Update Date | 23/03/2018 |