Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301109466 | MI |
NPI | 1598082117 |
---|---|
Provider Name | Tara Shankar |
First Address | Ann Arbor, MI 48103-1889 |
Second Address | Ypsilanti, MI 48197-1791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 14/07/2017 |