| NPI | 1992064257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: NH 054314-23) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NH 054314-23) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2014-07-23 |