| NPI | 1619350295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 278627) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301108417) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2019-07-08 |