| NPI | 1134485642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 83098) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 284611) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2019-10-10 |