NPI | 1720144637 |
---|---|
Former Name | CAUDREAN L. AVERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 200800028) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD430442) |
Enumeration Date | 2006-12-28 |
Last Update Date | 2020-10-25 |