| NPI | 1609852862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F360364-1) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CT 001006) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2007-07-08 |