Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301077006 | MI |
NPI | 1316158223 |
---|---|
Provider Name | Dr. Louise Anne Ruva |
First Address | Detroit, MI 48226 |
Second Address | Detroit, MI 48226-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |