Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1043766033 |
---|---|
Provider Name | Zazi Muller |
First Address | Brandywine, WV 26802-8656 |
Second Address | Brandywine, WV 26802-8656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2016 |
Last Update Date | 30/08/2016 |