| NPI | 1710140330 |
|---|---|
| Former Name | AGENA DAVENPORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 67408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2012-05-25 |