| NPI | 1053687012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-02757) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 9642995-1204) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2023-01-12 |