| NPI | 1790005452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: FL 9431448) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP010857) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2018-03-17 |