| NPI | 1679299762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: VA 24192027) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC 1051322) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2024-12-13 |