NPI | 1124525514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 95014249) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NJ 26NJ00763300) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NJ 26NJ00763300) | |
Enumeration Date | 2018-04-11 |
Last Update Date | 2021-09-15 |