| NPI | 1548636509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: ME CNP161198) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: WA AP60588602) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2016-11-30 |