| NPI | 1700930476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2010031879) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: KS 45997) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2015-12-16 |