| NPI | 1154319911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: ND R29615) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN R118302-3) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2015-08-26 |