| NPI | 1912956806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-12117) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: ID NP464A) |
| 207Q00000X Family Medicine (Licence: VA 0101252362) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2013-08-01 |