| NPI | 1790273506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID O-1657) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5151010915) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2023-01-19 |