| NPI | 1053570861 |
|---|---|
| Former Name | MICHELE DIANE JUSTICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101251837) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD49294) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2023-10-30 |