Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 01080908A | IN |
NPI | 1053701466 |
---|---|
Provider Name | Samira Molaei |
First Address | Greenwood, IN 46143-7241 |
Second Address | Lafayette, IN 47905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2015 |
Last Update Date | 15/03/2021 |