| NPI | 1164866281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MI 4301119365) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD60544845) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2021-02-24 |