| NPI | 1063794659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704362422) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 707787) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2023-05-25 |