| NPI | 1356888580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: GA RN302200) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-143545) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN302200) | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AL 1-143545) | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2021-08-02 |