| NPI | 1083703045 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ AP7036)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ RN053123)  | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ RN053123)  | |
| Enumeration Date | 2006-10-11 | 
| Last Update Date | 2018-09-04 |