| NPI | 1972708881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 125274) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2016-07-03 |