| NPI | 1770932626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 68098) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 68108-20) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2020-08-20 |