| NPI | 1053481085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA RN219155L) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA UP001577G) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2012-10-19 |