| NPI | 1114555158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5151014225) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151014225) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2022-06-24 |