| NPI | 1205809563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: LA AP06294) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TN 12388) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2010-10-01 |