Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301107276 | MI |
Y | 111NI0900X | Internist | 4301107276 | MI |
NPI | 1003200056 |
---|---|
Provider Name | Lindsey Aurora |
First Address | Detroit, MI 48202-2608 |
Second Address | Detroit, MI 48202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 05/07/2018 |