| NPI | 1760487037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61090693) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD21448) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-12-29 |