NPI | 1285771097 |
---|---|
Former Name | SHAUNA MARIE DILLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 176B00000X Midwife (Licence: CO 00000181) |
Additional Taxonomies | 175M00000X Midwife, Lay (Licence: CA LM 246) |
176B00000X Midwife (Licence: VT 107-0000036) | |
Enumeration Date | 2007-01-31 |
Last Update Date | 2022-05-10 |