| NPI | 1689790263 |
|---|---|
| Former Name | BETHANY D DOMZAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: TN 17251) |
| Additional Taxonomies | 176B00000X Midwife (Licence: GA 189322) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-03-22 |