| NPI | 1548664626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2017011922) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 05-39943) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2021-02-25 |