| NPI | 1477613511 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AZ AP1563)  | 
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: AZ RN102721)  | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ AP1563)  | |
| Enumeration Date | 2006-12-11 | 
| Last Update Date | 2023-03-07 |