Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301081348 | MI |
Y | 2080P0205X | Pediatric Endocrinologist | 4301081348 | MI |
NPI | 1104836725 |
---|---|
Provider Name | Joyce M Lee |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 14/10/2013 |