| NPI | 1629052279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: KY 3009083) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: IN 28175798A) |
| 363L00000X Nurse Practitioner (Licence: IN 71002851) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2021-04-15 |