Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 207V00000X | VA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 0101266924 | VA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2016-00379 | NC |
NPI | 1720344591 |
---|---|
Provider Name | Dr. Monique Hiersoux Vaughan |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 02/08/2021 |