| NPI | 1639415441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2012029476) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 75869) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2022-04-01 |