| NPI | 1972860914 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA 654511) | 
| Additional Taxonomies | 363LP1700X Nurse Practitioner, Perinatal (Licence: CA 654511) | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 654511) | |
| Enumeration Date | 2012-04-16 | 
| Last Update Date | 2012-04-16 |