| NPI | 1265576185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: IL 209.006994) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.006994) |
| 363LF0000X Nurse Practitioner Family (Licence: IA A-087782) | |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: IA F-087782) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2013-03-11 |