| NPI | 1639777915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA 10005049) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000240711) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: TN 28344) | |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2026-02-11 |