| NPI | 1104878495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 33432) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301106542) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-04-02 |