| NPI | 1538166921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: MA 72659) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 72659) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2011-12-05 |