| NPI | 1649564204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 59130) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101019225) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2026-01-27 |