NPI | 1295002160 |
---|---|
Former Name | ANTOINETTE INNIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 274484) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 2012-00137) |
Enumeration Date | 2011-11-21 |
Last Update Date | 2014-07-08 |