| NPI | 1073075123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 7955) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7955) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2022-07-19 |