| NPI | 1134357593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: VA 0102202941) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102202941) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0102202941) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2020-02-11 |