| NPI | 1588820765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 19564) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA 269680) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19564) | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2009-12-14 |