| NPI | 1780675140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704258909) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: WI 129854) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2014-07-16 |