| NPI | 1902984800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110425) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 54025) |
| 363LW0102X Nurse Practitioner Women's Health (Licence: NE 110425) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-09-01 |