| NPI | 1104469600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: GA RN228624) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN228624) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2024-01-17 |