| NPI | 1619985686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WY TL4276) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD60586432) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-03-05 |