| NPI | 1043697691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NY 298859-01) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2025-10-07 |