| NPI | 1114506805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2025-01813) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301513397) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MI 4301513397) | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-10-01 |