| NPI | 1710507264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: KY 3017181) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1158085) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-04-04 |