| NPI | 1679136550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME183838) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2026-08-12 |