| NPI | 1174769517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2002031370) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2002031370) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2017-06-09 |