| NPI | 1972749281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: VA 0017001194) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0017001194) |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: VA 0017001194) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2008-12-17 |