Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | VD041488 | MI |
NPI | 1013957893 |
---|---|
Provider Name | Dr. Vilma Drelichman |
First Address | Southfield, MI 48075-3707 |
Second Address | Southfield, MI 48075-3707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 17/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101679062 | (05) | MI |
B45622 | (02) | MI |