| NPI | 1073789228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA TP001523G) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA TP003002B) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2021-04-22 |