| NPI | 1053617407 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011001943) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2011001943) | 
| Enumeration Date | 2011-02-02 | 
| Last Update Date | 2022-10-07 |