| NPI | 1295817781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: PA OS005155L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA 05005155L) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2010-01-11 |