| NPI | 1053572537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2012-01056) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 148783) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2021-03-02 |