| NPI | 1487877619 |
|---|---|
| Former Name | AUDRA J ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M6628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY TL403) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-12-29 |