| NPI | 1063627362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA A108156) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301088413) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-04-13 |