| NPI | 1902921711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 65078) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC LL 29101) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2016-01-17 |