Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 04-23546 | KS |
NPI | 1134466444 |
---|---|
Provider Name | Dr. Elizabeth Gontero Hudek |
First Address | Fairway, KS 66205-2620 |
Second Address | Fairway, KS 66205-2620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2013 |
Last Update Date | 07/01/2013 |