| NPI | 1053354647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: OR 200250019NP WHCNP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200250020NP ANP-PP) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: OR 200250019NP WHCNP-PP) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2010-02-23 |