| NPI | 1164842456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 63833) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MN 63833) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2019-08-20 |