NPI | 1316939655 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NY 007986) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0079861) |
Enumeration Date | 2005-08-22 |
Last Update Date | 2019-12-10 |