| NPI | 1780904896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: GA 78039) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 078039) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2021-06-09 |