| NPI | 1801421664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3014434) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TN 27070) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-04-28 |