| NPI | 1376905349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101278933) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD465947) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2024-01-12 |