| NPI | 1649623091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A124725) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A124725) |
| 363LW0102X Nurse Practitioner Women's Health (Licence: IA A124725) | |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: IA A124725) | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2023-09-01 |