NPI | 1477845667 |
---|---|
Former Name | RENEE ANTONETTE WOODBURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: LA 328024) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-05-06 |
Last Update Date | 2021-09-15 |