| NPI | 1790015881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A130960) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10034436) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2016-05-19 |