Individual
DESTINY AIGHOBAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16001 W 9 MILE RD OFC, SOUTHFIELD, MI 48075-4818
(248) 849-8902
Mailing address
9504 EMPIRE ROCK ST, LAS VEGAS, NV 89143-1375
(678) 358-9748
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4351047009
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/03/2020
Last updated
06/06/2020
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