| NPI | 1154807881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 73034-20) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: WV 73034-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-09-12 |