| NPI | 1316202856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA 60656205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX T1653) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2025-10-10 |