| NPI | 1669589545 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 48010) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301078601) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-11-23 |