| NPI | 1164834875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 1016665) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NH 207V00000X) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2023-10-16 |