| NPI | 1699174854 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 95019569) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX AP126402) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2025-02-07 |