| NPI | 1649742560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: AL 1-150017) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 1-150017) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2023-09-11 |