| NPI | 1407115744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60638498) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301115177) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2022-11-08 |