| NPI | 1255956124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: KY 3014644) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: KY 3014644) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2022-12-16 |