| NPI | 1790709756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: GA RN104371) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN104371) |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN104371) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-01-02 |