Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4301101393 | MI |
NPI | 1003161811 |
---|---|
Provider Name | Kristin Inger |
First Address | Southfield, MI 48034-1258 |
Second Address | Detroit, MI 48235-2624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2012 |
Last Update Date | 31/08/2012 |