Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1073124194 |
---|---|
Provider Name | Aisha Ralph |
First Address | Round Rock, TX 78664-5742 |
Second Address | Round Rock, TX 78664-5742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2020 |
Last Update Date | 12/08/2020 |