| NPI | 1912251612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: WA AP60302039) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WA AP60302039) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2014-01-28 |