| NPI | 1508251182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NC 2019-00832) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2019-04-13 |