| NPI | 1598719825 |
|---|---|
| Former Name | MARY GRODA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00038716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 38085) |
| 208D00000X General Practice (Licence: WA MD00038716) | |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD00038716) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-11-01 |