| NPI | 1619490661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024174967) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: VA 0024174967) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2017-07-21 |