| NPI | 1831253079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704339051) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 515438) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2018-04-04 |