NPI | 1518040476 |
---|---|
Former Name | KRISTEAN ANN PORTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM MD2010-0196) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL TRN10143) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2025-03-18 |