| NPI | 1457846966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA 72721-21) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2023-07-31 |