| NPI | 1790853042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MD R091066) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R091066) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R091066) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2021-06-03 |