| NPI | 1508749532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL PA9120521) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-08-21 |