| NPI | 1114507688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CT 81719) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2025-07-17 |