| NPI | 1336368547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME101589) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 236615) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-09-20 |