| NPI | 1013965052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301088283) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 48332) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-02-22 |