| NPI | 1790030989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MD R158431) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NV APN001403) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2016-03-15 |