| NPI | 1750770699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AZ RN189894) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 19054) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2016-04-04 |