| NPI | 1215384003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: WA MD61435703) |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2026-01-30 |