| NPI | 1366454399 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 63743)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC TL29256)  | 
| 207V00000X Obstetrics & Gynecology (Licence: MD D0066161)  | |
| Enumeration Date | 2006-08-11 | 
| Last Update Date | 2020-08-20 |