| NPI | 1548696784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NC 5006317) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5006317) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2020-03-11 |