| NPI | 1790087112 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: AL 1-100927)  | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: AL 1100927)  | 
| Enumeration Date | 2010-11-18 | 
| Last Update Date | 2023-06-28 |