| NPI | 1710389937 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F421471) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 691239) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2024-04-04 |