| NPI | 1134273790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: CO 5849) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: TN 106129) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-07-24 |