| NPI | 1063482537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MI 4704119224) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704119224) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2019-02-28 |