Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 222722-3400 | UT |
NPI | 1033407200 |
---|---|
Provider Name | Mrs. Sarah Draper |
First Address | Hildale, UT 84784-0459 |
Second Address | Hildale, UT 84784-0459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 21/07/2011 |