| NPI | 1053471664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: DC RN33167) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN33167) |
| 363L00000X Nurse Practitioner (Licence: MD R088841) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2012-12-06 |