| NPI | 1104396829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R196482) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: MD R196482) |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |