Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A151537 | CA |
NPI | 1003279209 |
---|---|
Provider Name | Andrea Grace Henkel |
First Address | Washington, DC 20007-4806 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 16/07/2020 |