| NPI | 1962900209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: AL 1-148956) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1148956) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2020-09-15 |