| NPI | 1770825754 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NC 5011719)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 18211)  | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 18211)  | |
| Enumeration Date | 2013-03-18 | 
| Last Update Date | 2024-12-26 |