| NPI | 1063903813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS21175)  | 
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL OS21175)  | 
| 208600000X Surgery (Licence: MI 5101027291)  | |
| Enumeration Date | 2018-05-27 | 
| Last Update Date | 2025-10-15 |