| NPI | 1801120050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 001003316) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01330) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2012-03-21 |