| NPI | 1053533935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MI 209667) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 15778) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2024-08-21 |