| NPI | 1508043985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: IA A104052) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 104052) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2015-04-22 |