| NPI | 1437613874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: UT 7963320) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7963320-3102) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 7963320-4405) | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2020-03-05 |