Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 4301111422 | MI |
NPI | 1245487438 |
---|---|
Provider Name | Dr. Elora Hussain |
First Address | Grand Rapids, MI 49503-4950 |
Second Address | Grand Rapids, MI 49503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 17/02/2021 |