| NPI | 1053791673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME141730) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN21695) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2019-07-19 |