Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301405874 | MI |
N | 2084N0402X | Child Neurologist | 4301405874 | MI |
NPI | 1013927631 |
---|---|
Provider Name | Elizabeth A Garofalo |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-0318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1900265 | (05) | MI |
B48776 | (02) |