| NPI | 1790985570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA RN546469) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP009536) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2012-07-31 |