| NPI | 1750659777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MO 2011028689) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: KS 75395) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2017-10-30 |