| NPI | 1912086901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 5017079) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F420722-1) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-01-04 |