Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4301047843 | MI |
NPI | 1093741894 |
---|---|
Provider Name | Dr. Laryssa N Kaufman |
First Address | East Lansing, MI 48824-7015 |
Second Address | East Lansing, MI 48824-1313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 07/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1567496 | (05) | MI |
A78993 | (02) | MI |