| NPI | 1710081450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID O-217) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA OP00001645) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2015-05-13 |