| NPI | 1548643802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 869656) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 869656) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MS 869656) | |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2019-09-24 |