| NPI | 1043650682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO162069) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 61159) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2016-11-09 |