| NPI | 1013285725 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 1034362) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY 593676) | 
| Enumeration Date | 2011-12-08 | 
| Last Update Date | 2021-12-28 |