| NPI | 1518079086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704174012) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704174012) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-09-25 |