| NPI | 1467867119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 57.245320) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2014018988) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2019-04-17 |