| NPI | 1356640031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 63455) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD D0079300) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2019-01-24 |