| NPI | 1194808097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 28041) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: IN 01057157A) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-09-08 |