| NPI | 1093085268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1113617)  | 
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AL 1-113617)  | 
| Enumeration Date | 2012-01-05 | 
| Last Update Date | 2020-05-06 |