| NPI | 1407481708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101272782) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 171000000X Military Health Care Provider (Licence: VA 0101272782) | |
| 208D00000X General Practice (Licence: VA 0101272782) | |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2026-07-22 |