Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301090171 | MI |
Y | 2080P0216X | Pediatric Rheumatologist | 4301090171 | MI |
NPI | 1417150103 |
---|---|
Provider Name | Smriti Mohan |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 30/09/2020 |