| NPI | 1770963423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX T5831) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208667) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2025-08-04 |