| NPI | 1427066455 |
|---|---|
| Former Name | SANDRA J PROVINES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 176B00000X Midwife (Licence: MS 899566) |
| Additional Taxonomies | 176B00000X Midwife (Licence: KY 3016943) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2021-12-01 |