Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 2901013249 | MI |
NPI | 1013028836 |
---|---|
Provider Name | Josephine Finazzo |
First Address | Grosse Ile, MI 48138-1385 |
Second Address | Livonia, MI 48152-2048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |