| NPI | 1407812456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L0726) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 212381-1) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-08 |