| NPI | 1205463460 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F421428) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 1192122) | 
| Enumeration Date | 2020-03-26 | 
| Last Update Date | 2025-08-07 |