| NPI | 1104466523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 1015332) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 770276) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2021-02-09 |