| NPI | 1700442910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5151013428) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 73927) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2023-06-05 |