Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301089906 | MI |
N | 207VX0000X | Obstetrician | 4301089906 | MI |
NPI | 1376749366 |
---|---|
Provider Name | Dr. Audrey Ann Lance |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4276 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 26/04/2012 |