| NPI | 1801364963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024176780) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001233010) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |