| NPI | 1306623517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2389929) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 209.028249) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2025-11-14 |