NPI | 1326432220 |
---|---|
Former Name | KOURTNEY LYNN TRUDGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DC MTL002932) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 53198) |
Enumeration Date | 2015-03-27 |
Last Update Date | 2021-07-26 |