| NPI | 1912210063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 55618) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT198030) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 106376) | |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2019-11-19 |