| NPI | 1164842456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 320846) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MN 63833) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 63833) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2025-08-25 |