| NPI | 1205822095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA VP000677G) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NJ 26NN06254500) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2021-04-29 |