| NPI | 1124118740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: UT 211706-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 211706-4405) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-12-21 |