| NPI | 1740453539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 46804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44397) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: WY 46804) | |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2025-09-08 |