| NPI | 1093924391 |
|---|---|
| Former Name | MICHAEL T HAILEMARIAM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: AL 34547) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 34547) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2018-09-10 |