NPI | 1972865475 |
---|---|
Former Name | MALLORY MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.134798) |
Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY 51848) |
207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: IN 01089150A) | |
Enumeration Date | 2012-06-11 |
Last Update Date | 2023-01-11 |