Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 4301096436 | MI |
N | 208000000X | Pediatrician | 4301096436 | MI |
NPI | 1356654586 |
---|---|
Provider Name | Amy Delaroche |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201-2119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2010 |
Last Update Date | 06/06/2016 |