Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1871672964 |
---|---|
Provider Name | Dr. Sandra L Nehlsen-Cannarella |
First Address | Detroit, MI 48201-2018 |
Second Address | Detroit, MI 48201-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |