| NPI | 1811301831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 74492-20) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301105186) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2021-04-05 |