Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 35096551 | OH |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 4301081190 | MI |
N | 207VG0400X | Gynecologist | 4301081190 | MI |
N | 207VX0000X | Obstetrician | 4301081190 | MI |
NPI | 1306068978 |
---|---|
Provider Name | Maria Victoria Cruz Estanol |
First Address | Troy, MI 48083-1103 |
Second Address | Royal Oak, MI 48073-6770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 12/08/2013 |