| NPI | 1689019507 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301111652)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2013-05-06 | 
| Last Update Date | 2020-05-04 |