Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 5951001415 | MI |
NPI | 1003494386 |
---|---|
Provider Name | Zienab Dabaja |
First Address | Wyandotte, MI 48192-4668 |
Second Address | Wyandotte, MI 48192-4668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2021 |
Last Update Date | 23/06/2021 |