| NPI | 1922413962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: FL APRN9296630) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9296630) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2020-08-05 |