Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 4301061553 | MI |
NPI | 1003878109 |
---|---|
Provider Name | Dr. Debora Ann Kaczynski |
First Address | Ann Arbor, MI 48108-2783 |
Second Address | Dearborn, MI 48124-5032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 25/03/2014 |