| NPI | 1629095310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WY 4077A) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD61388529) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-03-06 |