| NPI | 1134636012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175569) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 0024175569) |
| 363LW0102X Nurse Practitioner Women's Health (Licence: VA 0024175569) | |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2021-02-23 |