| NPI | 1821319468 |
|---|---|
| Former Name | CRYSTAL BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX P9304) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX P9304) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2015-03-23 |