| NPI | 1144584012 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PR 19237) | 
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NY 283389) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-26 | 
| Last Update Date | 2018-07-19 |