| NPI | 1962931170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD486714) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57030472) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2024-09-22 |