| NPI | 1376259770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: ID 85284) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 75284) |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-06-05 |