| NPI | 1386919587 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 77834)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0056706)  | 
| Enumeration Date | 2012-03-21 | 
| Last Update Date | 2019-03-12 |