NPI | 1952857385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-78141) |
Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MN 65709) |
Enumeration Date | 2016-08-26 |
Last Update Date | 2020-09-15 |