| NPI | 1205823960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 35173) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: WI 35173) |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2007-07-08 |