| NPI | 1104366806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: WY 39183.1599) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: SD CP001163) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |