| NPI | 1760097802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: UT 12818167-4405) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA RN2335225) | 
| Enumeration Date | 2020-09-15 | 
| Last Update Date | 2023-03-29 |