| NPI | 1093211849 |
|---|---|
| Former Name | CHARLOTTE J BALLENTINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: AL 43471) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-06-30 |