| NPI | 1861480485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MS 902222) | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 15659) | 
| Enumeration Date | 2005-10-07 | 
| Last Update Date | 2018-01-08 |