| NPI | 1558325159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 637) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC APN637) | 
| Enumeration Date | 2006-04-12 | 
| Last Update Date | 2018-06-19 |