| NPI | 1063189215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015039) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 0000) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2021-10-18 |