| NPI | 1376596270 |
|---|---|
| Former Name | STACEY A BOMGAARS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00047218) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD27170) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2010-09-29 |