| NPI | 1720366289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111181) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 64983) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: NE 111181) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-01 |