| NPI | 1104464999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 104901) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: WV 104901) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2020-04-08 |