Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 4301090956 | MI |
NPI | 1003112517 |
---|---|
Provider Name | Jeanjiko D Cuison |
First Address | Lansing, MI 48911-4002 |
Second Address | Lansing, MI 48911-4002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2011 |
Last Update Date | 31/01/2011 |