Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 5101018161 | MI |
N | 2080N0001X | Neonatal-Perinatal Doctor | 5101018161 | MI |
NPI | 1144450313 |
---|---|
Provider Name | Dr. Monica Maka Nafsou |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 03/12/2015 |