| NPI | 1093820698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: OR 200850011NP) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: OR 200650009NP) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2014-10-08 |