| NPI | 1851670913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: CT 004712) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 4712) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2016-03-08 |