| NPI | 1154478584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 42197) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 42610) |
| 207V00000X Obstetrics & Gynecology (Licence: WI 47685) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-09-16 |