| NPI | 1750763637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2022-02951) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101260834) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2023-09-18 |