| NPI | 1053975284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NC 5012975) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 184955) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2022-02-08 |