| NPI | 1053393553 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 3891)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR DO25177)  | 
| 207V00000X Obstetrics & Gynecology (Licence: CA 20A8886)  | |
| Enumeration Date | 2005-11-18 | 
| Last Update Date | 2018-01-10 |