Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 4301101629 | MI |
N | 208000000X | Pediatrician | 4301101629 | MI |
NPI | 1326250564 |
---|---|
Provider Name | Leigh Flore |
First Address | Detroit, MI 48219 |
Second Address | Detroit, MI 48201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 14/08/2012 |