| NPI | 1194055111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 53-75299-111) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AR A03322 APN) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2011-08-15 |