Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1063548121 |
---|---|
Provider Name | Ms. Monique Gauthier |
First Address | Shutesbury, MA 01072-9703 |
Second Address | Shutesbury, MA 01072-9703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2007 |
Last Update Date | 08/07/2007 |