| NPI | 1477641546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 13163) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 594657) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-05-08 |