| NPI | 1700374394 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX T4362)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301114618)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-29 | 
| Last Update Date | 2022-06-05 |