| NPI | 1609294065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: VA 0101279157) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101279157) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2023-12-04 |