| NPI | 1124172762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO RN099746) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 099746) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-09-24 |