Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 13008937A | IN |
NPI | 1033785985 |
---|---|
Provider Name | Sanya Hatimi |
First Address | Kokomo, IN 46902-3790 |
Second Address | Frankfort, IN 46041-2742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2021 |
Last Update Date | 01/06/2021 |