| NPI | 1982965034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 9732284-1204) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101019941) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2016-06-24 |