| NPI | 1679153597 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: TX 1023951) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1023951) | 
| Enumeration Date | 2021-04-13 | 
| Last Update Date | 2021-05-05 |