| NPI | 1962698514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WY 14569.0146) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WY 14569.146) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2012-02-01 |