| NPI | 1215963426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: ND R39847) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 684133) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 684133) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-03-29 |