| NPI | 1114542586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD 24525) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: SC 24525) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2022-05-25 |