| NPI | 1053803601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2022-01690) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 310899) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT215153) | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2024-10-03 |