| NPI | 1700144623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX AP142301) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2013028583) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704288531) | |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2022-03-01 |