| NPI | 1811712151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NC 5021217) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021217) |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2025-11-05 |