| NPI | 1174954820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MD R218833) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001235806) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024171089) | |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2015-12-30 |