| NPI | 1790307098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2024-01859) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4351046183) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-09-06 |