| NPI | 1639496904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60425439) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD 6402) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2023-02-03 |