Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25821 | NE |
NPI | 1104060748 |
---|---|
Provider Name | Michelle Lora Floyd |
First Address | Maxwell Afb, AL 36112 |
Second Address | Maxwell Afb, AL 36112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2009 |
Last Update Date | 18/11/2021 |