| NPI | 1417593898 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP021202) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP021202) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2025-02-19 |