| NPI | 1245525955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID NP-1066A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID NP-1066A) |
| 363LF0000X Nurse Practitioner Family (Licence: IA A133515) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2020-12-16 |