| NPI | 1255354577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA VP001872G) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA VP001872G) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-08-22 |