| NPI | 1215143383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 104961) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57.011547) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-03-19 |