| NPI | 1720109556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: GA 062996) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 062996) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2015-04-16 |