| NPI | 1255029666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024193113) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN715407) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP028576) | |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2025-05-06 |