| NPI | 1770929895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 10633362-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 9408465) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2019-09-17 |