| NPI | 1215431960 |
|---|---|
| Former Name | MARISSA LUCK BONUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: OR MD209009) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD209009) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2025-05-13 |