| NPI | 1609414010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IA A157325) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A157325) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2020-01-10 |