| NPI | 1245389188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: VA 0024072427) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001072427) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-10-13 |