| NPI | 1578558334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 37782) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 41185-020) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2016-01-29 |