| NPI | 1831740497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: GA RN181146) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 23263) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2023-05-18 |