| NPI | 1205147550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 03754) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101018894) |
| 207V00000X Obstetrics & Gynecology (Licence: KY TP023) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2020-01-07 |