| NPI | 1912261322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2016020752) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 1071441) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 56923) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-03-17 |