| NPI | 1164579462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA 261973) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN261973) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2026-09-14 |