| NPI | 1124023122 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NH 081278-23) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 533226) | 
| Enumeration Date | 2005-06-16 | 
| Last Update Date | 2020-11-19 |