| NPI | 1114152873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA TP006878G) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN187433L) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2012-01-18 |