| NPI | 1104021559 |
|---|---|
| Former Name | ANDREA LAREINA OEY KUNTARAF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NC 201400046) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57-012298) |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2010-00276) | |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2021-02-19 |