| NPI | 1700194107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024173436) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME AP101061) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2016-04-14 |