| NPI | 1003968512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 164162-1) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 164162) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-09-07 |