| NPI | 1639231673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: RI CMD13051) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 239751) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2018-03-17 |