Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 4301089592 | MI |
NPI | 1033232319 |
---|---|
Provider Name | Denise Ann-Marie John |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48105-1912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 23/03/2012 |