| NPI | 1053874248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704207173) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN 12096) |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2024-11-15 |