| NPI | 1144426594 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301101696)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 141238)  | 
| Enumeration Date | 2007-06-22 | 
| Last Update Date | 2012-08-09 |