| 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, Psych/Mental Health (Licence: NH 054314-23) | 
| Enumeration Date | 2012-05-08 | 
| Last Update Date | 2014-07-23 |