| NPI | 1154704930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 65104) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 7584) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2019-07-09 |