| NPI | 1558609644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: CA 95000900) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 0990582) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2017-04-19 |