Gustavo Fernando Tataje Rengifo
ActiveMichigan license 4301504688
License
- Licensed by
- Michigan Department of Licensing and Regulatory Affairs
- License number
- 4301504688
- Status
- Active
- First issued
- June 24, 2021
- Expires
- June 24, 2027
- License holder
- Gustavo Fernando Tataje Rengifo
- Entity type
- Individual
Classifications
- Medical Doctor (Medicine) Physicians & Surgeons