Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 7601000002 | MI |
NPI | 1144876442 |
---|---|
Provider Name | Araya M Montero |
First Address | Traverse City, MI 49686-1529 |
Second Address | Traverse City, MI 49686-1529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2019 |
Last Update Date | 13/08/2019 |