| NPI | 1053601526 |
|---|---|
| Former Name | ERIN LEANN FORTENBERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 56051) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD454284) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2022-03-25 |