| NPI | 1780786038 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA 110333)  | 
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MA 110333)  | 
| Enumeration Date | 2006-09-05 | 
| Last Update Date | 2012-10-12 |