Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301504752 | MI |
Y | 111NI0900X | Internist | 4301504752 | MI |
N | 207RH0002X | Hospice and Palliative Medicine | 4301504752 | MI |
NPI | 1265827927 |
---|---|
Provider Name | Galyna Clous |
First Address | Grawn, MI 49637-9419 |
Second Address | Lansing, MI 48912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 02/08/2021 |