| NPI | 1063891265 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 82712)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2015-05-21 | 
| Last Update Date | 2019-06-14 |