Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301069923 | MI |
Y | 207VE0102X | Reproductive Endocrinologist | 4301069923 | MI |
NPI | 1447343652 |
---|---|
Provider Name | Laura April Gago |
First Address | Brighton, MI 48114-7004 |
Second Address | Brighton, MI 48114-7004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4630655 | (05) | MI |
I15246 | (02) | MI |