| NPI | 1053626044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA RN2338721) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL ARNP 9179255) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2020-02-03 |