| NPI | 1124440102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2014005732) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA F148416) |
| 363LW0102X Nurse Practitioner Women's Health (Licence: MO 2014005732) | |
| 363LW0102X Nurse Practitioner Women's Health (Licence: IA F148416) | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2025-07-06 |