| NPI | 1023161262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD171024) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207V00000X Obstetrics & Gynecology (Licence: NE 24857) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA 133637) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2022-02-04 |