Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A154692 | CA |
NPI | 1134548399 |
---|---|
Provider Name | Mary Micaela Rieger |
First Address | San Diego, CA 92103-1911 |
Second Address | Austin, TX 78701-1907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 17/07/2018 |