| NPI | 1558689646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024168775) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: OH COA12163-NP) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2012-03-08 |