| NPI | 1710975552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA TP 003616G) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN243934L) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP007604) | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA SP007604) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-04-20 |