| NPI | 1780920009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NY F421255-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626663) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2019-12-19 |