| NPI | 1700172111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2016-01928) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2011014993) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-09-08 |