Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 125.065530 | IL |
NPI | 1013335504 |
---|---|
Provider Name | Evelyn Hall |
First Address | Ann Arbor, MI 48104-1433 |
Second Address | Ann Arbor, MI 48104-1433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2014 |
Last Update Date | 04/05/2016 |