Individual
MRS. LARA YATOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202
(313) 916-2600
Mailing address
7432 RAFFORD LN, WEST BLOOMFIELD, MI 48322-3194
(248) 217-9888
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704279927
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704279927
MI
Other
Enumeration date
10/06/2015
Last updated
02/17/2021
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