| NPI | 1154424950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: UT 2005154405) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: UT 2005154405) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-03-26 |