| NPI | 1104810712 |
|---|---|
| Former Name | LESLIE A DETRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G51253) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA G51253) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2013-09-19 |