| NPI | 1902057490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA 506488) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 302855) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NY 420499-1) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2022-04-14 |