| NPI | 1720457005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 5376910032) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2015037208) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2016-02-04 |