| NPI | 1245539998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY TP190) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 01002205081) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: KY TP190) | |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2022-11-30 |