| NPI | 1588665061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ AP4264)  | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA tp-000357-g)  | 
| Enumeration Date | 2005-08-09 | 
| Last Update Date | 2014-05-14 |