NPI | 1811213309 |
---|---|
Former Name | KATHERINE GRACE HAAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 11640813-1205) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 56840-20) |
207V00000X Obstetrics & Gynecology (Licence: MA 275442) | |
Enumeration Date | 2010-04-09 |
Last Update Date | 2021-11-03 |