| NPI | 1194743302 |
|---|---|
| Former Name | TAWANNA O GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101244776) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 055753) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD424859) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-03-07 |