| NPI | 1104153766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704253301) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: FL TPAN2221) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2024-07-25 |