| NPI | 1821879560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN 10610) | 
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN 10610) | 
| Enumeration Date | 2023-10-09 | 
| Last Update Date | 2023-10-11 |