| NPI | 1790744894 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA 95006490)  | 
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WI 829)  | 
| Enumeration Date | 2006-03-20 | 
| Last Update Date | 2019-09-17 |