NPI | 1760001960 |
---|---|
Former Name | MARCELLA RILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME168224) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-09 |
Last Update Date | 2024-05-06 |