Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MT201379 | PA |
Y | 207VX0201X | Gynecologic Oncologist | MD457669 | PA |
NPI | 1538427406 |
---|---|
Provider Name | Ashley Brooke Graul |
First Address | Fountain Hill, PA 18015-1153 |
Second Address | Fountain Hill, PA 18015-1153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2012 |
Last Update Date | 08/07/2019 |