Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1043770613 |
---|---|
Provider Name | Mr. Thomas Mcwilliams |
First Address | Ann Arbor, MI 48105-9684 |
Second Address | Ann Arbor, MI 48105-9684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2019 |
Last Update Date | 20/03/2019 |