| NPI | 1982982583 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60632832)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09703400)  | 
| Enumeration Date | 2011-07-30 | 
| Last Update Date | 2022-07-21 |