| NPI | 1790200749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NH 07639823) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: VT 101.0134359) | 
| Enumeration Date | 2017-08-11 | 
| Last Update Date | 2022-12-11 |