| NPI | 1104072719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 681341) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 681341) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |