| NPI | 1831360411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: TN 13309) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TN APN0000013309) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2015-08-05 |