| NPI | 1568996130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-02712) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 40738) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2021-10-15 |