Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301103849 | MI |
NPI | 1780028829 |
---|---|
Provider Name | Mrs. Keturah Williams Jeffries |
First Address | Detroit, MI 48201-1916 |
Second Address | Detroit, MI 48201-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 20/09/2019 |