| NPI | 1720192883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MI 4704158381) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704158381) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2010-11-04 |