Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | L2312183 | MI |
NPI | 1407194582 |
---|---|
Provider Name | Dr. Timothy Milano |
First Address | Howell, MI 48843-6583 |
Second Address | Howell, MI 48843-6583 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2013 |
Last Update Date | 10/01/2014 |