| NPI | 1386954816 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WI 4233)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 155895)  | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: WI 4233)  | |
| Enumeration Date | 2010-10-18 | 
| Last Update Date | 2016-01-30 |