Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1326671710 |
---|---|
Provider Name | Similoluwa J Oyinkolade |
First Address | Hamtramck, MI 48212-3736 |
Second Address | Dearborn, MI 48124-2044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2020 |
Last Update Date | 19/02/2020 |