| NPI | 1114527082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MO 2020015820) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MO 2020019674) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |