| NPI | 1811262405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 20893) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA 1948) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2014-10-02 |