| NPI | 1154812964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IA 56640) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 52450) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2026-04-27 |