| NPI | 1578196366 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: OH .023665)  | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP021504)  | 
| 363L00000X Nurse Practitioner (Licence: PA SP021504)  | |
| Enumeration Date | 2020-02-19 | 
| Last Update Date | 2025-06-30 |