| NPI | 1467666388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME157180) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A100110) |
| 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08016700) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-10-06 |