| NPI | 1275947293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61103035) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 63639) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301104905) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2021-04-05 |