Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 4301105074 | MI |
NPI | 1316357965 |
---|---|
Provider Name | Alexandra Teodora Chis |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2014 |
Last Update Date | 11/07/2018 |