| NPI | 1154540193 |
|---|---|
| Former Name | POTACIA WYNETTE BRISTOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD459185) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 243207-1) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: GA 63330) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2017-05-10 |