| NPI | 1629647219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 79871) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 9037) |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2025-06-12 |