| NPI | 1790266161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 101790851) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2025-06-27 |