Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 4301105050 | MI |
Y | 208800000X | Urologist | 4301105050 | MI |
NPI | 1174758262 |
---|---|
Provider Name | Dr. Priyanka Gupta |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 26/09/2016 |