| NPI | 1942552559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ROGERS Credentialing Specialist 231-392-0655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: MI 4704273686) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2016-02-24 |