| NPI | 1104188697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 178891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 982) |
| 207Q00000X Family Medicine (Licence: AL MD34378) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: AL 34378) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2022-08-19 |