| NPI | 1922562693 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 36149) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6197714) | 
| Enumeration Date | 2019-01-28 | 
| Last Update Date | 2022-07-20 |