Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 269937 | MA |
Y | 207YS0123X | Facial Plastic Surgeon | 4301100481 | MI |
NPI | 1508125063 |
---|---|
Provider Name | Laura Rubi Garcia-Rodriguez |
First Address | Detroit, MI 48202-2608 |
Second Address | Detroit, MI 48202-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 04/08/2018 |