Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301086322 | MI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 4301086322 | MI |
NPI | 1083895338 |
---|---|
Provider Name | Meret Henry |
First Address | Detroit, MI 48201-2119 |
Second Address | Detroit, MI 48201-2119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2007 |
Last Update Date | 19/07/2011 |