| NPI | 1962704726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VT 101.0072674) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F421020-1) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2018-09-13 |