| NPI | 1205507589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 95020313) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: OH 0029806) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OH aprn.cnp.0029806) | |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2024-10-30 |