| NPI | 1629400734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP1318A) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: ID NPpend) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2022-04-15 |