| NPI | 1104271691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 34.014629) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2021-02085) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OH 34.014629) | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2024-11-21 |