| NPI | 1669812079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX S4059) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301103752) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2019-11-05 |