| NPI | 1104210194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: GA RN221177) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN133392) |
| 363L00000X Nurse Practitioner (Licence: CA 95002527) | |
| 363LW0102X Nurse Practitioner Women's Health (Licence: LA AP08578) | |
| 163W00000X Registered Nurse (Licence: CA RN95062945) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-07-15 |