| NPI | 1649686874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 289619) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 315372-1) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2021-07-06 |