Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99378 | TX |
NPI | 1033413570 |
---|---|
Provider Name | Michelle Leigh Gold |
First Address | Austin, TX 78759-3550 |
Second Address | Austin, TX 78759-3550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2010 |
Last Update Date | 02/07/2019 |