| NPI | 1265633424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: GA 74438) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: LA MD204838) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: SC 36645) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2024-12-13 |