| NPI | 1982009312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2014029927) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 53-76560) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2016-10-12 |