| NPI | 1538790092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024178789) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TN 27125) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2021-06-11 |