Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 4301104988 | MI |
NPI | 1063707958 |
---|---|
Provider Name | Dr. Misako Nagasaka |
First Address | Novi, MI 48375-1764 |
Second Address | Detroit, MI 48201-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2011 |
Last Update Date | 17/03/2018 |