NPI | 1649363755 |
---|---|
Former Name | CRISTA E JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 1013899) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 40882) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2023-05-18 |