| NPI | 1548444011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: IL 209007742) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 152008) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2009-09-09 |