| NPI | 1760878524 |
|---|---|
| Former Name | HALEY DEATHERAGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2023-00258) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 59124) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2024-04-24 |